Rachel becomes increasingly withdrawn as she repeatedly miscarries. Bilhah offers to go to Jacob and bear a son on her behalf. Rachel accepts her offer gratefully, and Jacob agrees. Bilhah goes to his tent that very night and returns the next day no longer a maiden but not a true bride of Jacob. Jacob calls Bilhah to him often, as Rachel is frequently away attending births and Leah is nursing. Bilhah becomes pregnant and gives birth to a healthy boy, Dan. By law, since she is Rachel’s handmaiden and not Jacob’s true bride, the baby belongs to Rachel. Rachel has grown kindhearted from her experiences delivering babies and places the boy in Bilhah’s arms. Rachel’s desire for children is reaffirmed, and she goes to Jacob and begs him to give her children. They find pleasure with each other again.

Leah commands Zilpah to go to Jacob’s bed for the first time. Zilpah goes, hoping that at twenty-five she is too old to bear children. She takes no pleasure in Jacob’s touch but performs her duty. She conceives and dreams of giving birth to a daughter. When her time comes, the labor lasts for three days and she gives birth to twins, Gad and Asher. Zilpah, half‑dead, lies still for several days. Soon after, she tells Jacob that she has given him two sons but that another pregnancy will kill her. He never calls her to his bed again. Leah’s next pregnancy also brings twin boys, Naphtali and Issachar.

Jacob now has four wives and ten sons. He is uneasy, however, as technically Laban owns most everything he tends. Laban treats his daughters cruelly, growing fat off the profits of his son‑in‑law and beating his wife, Ruti. One day, Ruti begs Rachel for an herb to end her pregnancy, for she does not want to give Laban another son. Rachel and her sisters agree to perform an abortion at the next new moon. The new moon comes, and in the red tent Rachel mixes a strong black brew which Ruti drinks. She miscarries quickly but does not cry out in pain.

After seven sons, Leah feels that she can no longer give birth. She drinks fennel to prevent pregnancy but runs out of the herb. Leah realizes she has become pregnant again and asks Rachel to help her miscarry as Ruti did. Rachel tells her not to do it, since she carries a girl. Rachel offers to take on Leah’s workload during her pregnancy. Leah agrees, and the sisters begin to dream collectively about the arrival of their first daughter.

Dinah is born in an easy birth, with Leah supported on the midwife’s brick on all sides by her sisters and Inna. Dinah stays in the red tent with her mother for the first two months, and the sisters shower her with affection. Just after Dinah’s birth, Rachel finally conceives. In her eighth month, she begins to feel sick. She grows pale and her hair falls out. Inna arrives to assist and discovers that the baby is breech birth, with its legs coming out first. Inna tries to turn the baby around, and two days pass while Rachel screams and bleeds. After three days and three nights, the baby turns. The baby Joseph is born small and wrinkled. Rachel recovers slowly but cannot breastfeed. The duty falls to Leah, who is nursing Dinah already.

As the abused wife of Laban, the fictional character of Ruti stands outside the tight-knit community of women in Jacob’s tribe. Ruti’s character has no roots in the Bible and is completely Diamant’s creation. Through Ruti, Diamant illustrates the hopeless circumstances of an abused wife and draws a cruel sketch of Laban’s character. Ruti is not a dowered wife like Leah and Rachel, nor does she have a family around her to provide support. She is at the beck and call of an abusive husband and living at a time where she has no recourse for his actions. Laban takes no care to treat his wife well and uses her as a slave, teaching their sons to treat her in the same manner. There is a contrast between Laban’s treatment of Ruti and Jacob’s treatment of his four wives. While the polygamist family is not without its problems, it does not compare to Ruti’s abusive family situation. Ruti attempts to resist Laban’s authority by refusing to give him another son and, in doing so, maintains a measure of control over her body. The women rush to her aid and support her within the world of the red tent. Outside the tent, she is not one of them, and they ultimately keep their distance to avoid trouble.

Rachel’s character undergoes a metamorphosis throughout the first several chapters of the novel—from a childish, spoiled beauty into a strong, talented healer. She has difficulty conceiving a child and thus must find fulfillment in other areas of her life. Through her practice as a midwife, Rachel develops a sense of her own power and an identity other than just being the beauty. Though she is not as lucky in childbearing as her sisters, she cultivates her own kind of power in the red tent. By serving mothers in birth, she finds her own humanity and tenderness. As a result of this fundamental change in her personality, coupled with the joy of Dinah’s birth, she opens herself up to Jacob again. Fully confident now in her status as a woman, her womb seems to strengthen, and she is able to carry the baby to term. Dinah’s birth also contributes to the softening of her relationship with Leah. Without the constant jealousy, Rachel becomes more relaxed and accepting. Despite her experience in attending births, her own labor is difficult and she nearly dies, but her will to give Jacob a son and finally hold her own child in her arms prevails. The last vestiges of the old Rachel emerge when she resents handing her son to her fertile sister to breastfeed when her own breasts cannot feed him, but she at last accepts the situation.

Dinah’s troubled entrance into the world foreshadows her difficult life. After countless miscarried female babies among the sisters, Leah conceives yet another girl. The birth of so many sons has left Leah tired and she cannot bear the thought of another pregnancy and childbirth. Dinah’s destiny as the daughter of the wives of Jacob becomes clear when Rachel, an unlikely candidate, encourages Leah to keep the baby. After years of divided loyalties and emotions, the two sisters find something to rejoice about together and they dream of one girl who will live on as the legacy of the four sisters. Dinah is anxiously dreamed of for months, then is born into four pairs of loving hands. Dinah’s dramatic welcome to the world suits a character that is later the catalyst for the slaughter of a city.